This chapter describes nursing care for sleep disorders in the primary care setting. The most prevalent sleep disorders in adults and older adults, and those most commonly seen in primary care settings are insomnia, sleep-disordered breathing, and restless legs syndrome. There is a compelling need for widespread access to sleep assessment and treatment among the large population of primary care clients who have sleep disorders-many of which are currently undetected. Primary care providers, especially nurses, are in an ideal position to assess, implement, and evaluate sleep promotion and sleep disorders treatment in primary care clients. The reach, adoption, implementation, and long-term maintenance of sleep promotion and sleep disorders treatment is most likely to be successful if implemented at the practice/organizational level. Nurses, especially advanced practice nurses play a pivotal role in implementing and evaluating policies and procedures to assure the translation and uptake of these important services.

Faith community nurses (FCNs) are called upon to provide spiritual care as well as traditional nursing care, both in institutional settings and in the home, to congregants who suffer from chronic illness, have had surgery, or have had an accident. After conducting a holistic assessment of a patient who is chronically ill, a FCN can help the patient and his or her family copes with the disease and can provide comfort by listening, just being present, reading scripture, and/or praying. Sudden, unanticipated acute illness may pose serious emotional and spiritual problems related to fear of possible death or disability. Psychological depression may result from severe pain or fatigue. The leading chronic diseases in developed countries include arthritis, cardiovascular disease such as heart attacks and stroke, cancer such as breast and colon cancer, diabetes, epilepsy and seizures, obesity, and oral health problems.

This chapter talks about becoming a mentor-leader: Beliefs and behaviors, mentoring across cultures and generations, and mentor as Pygmalion: Believing in potential and expecting success. Nurses can learn leadership by observing good leaders, mentors, and role models; studying leadership theories and research; testing leadership behaviors through work and professional association activities; and using reflective learning to develop and fine-tune nurse’s behaviors. Mentor-leaders are present in every cultural and ethnic group and in every generation. Global, cross-cultural, and cross-generational mentoring occur when nurses are open and receptive to learning from each other and are willing to share their unique perspectives and skills. The nursing profession has an impressive track record of global collaboration and mentorship. Through mentor bonds that break down global and cultural boundaries, nurses have unprecedented opportunities for driving change in health and nursing around the world.

Nursing care makes the author and her work special and her satisfaction in being a nurse is the smile of her patients and their families. A wonderful part of her career has been the chance to learn from different kinds of people and cultures: nurses and doctors from different nursing and medical schools in Haiti as well as nurses and doctors from foreign countries. The more the nurses and doctors understand, the more they know how important it is to give the medication on time, to pay attention to a patient’s diet, intake and output, to check his weight and height, to take his blood pressure, and evaluate his heart rate before administering certain kinds of medication. After 1 year of clinical practice the author was promoted to nurse manager of the pediatric ward. This wonderful experience helped the author to develop her leadership and management abilities.

The components of the CARES tool can provide a basis for a nursing care model specific to the care of the dying, their families, and for individuals who provide care for the dying. There are three immediate subgroups that address the most common needs and/or issues when caring for the dying. The three subgroups are symptom management, emotional and spiritual care, and self-care. Symptom management is divided into the three most common symptom management needs of the dying and their families found in peer-reviewed literature, and include comfort, airway, and restlessness and delirium. Nurses caring for the dying individual play an important role in the promotion of comfort. Education is a component of all the subgroups in the CARES tool model to emphasize the need for the nurse to seek additional training and knowledge about the care of the dying.

This chapter enables the readers to identify methods to assess: psychosocial well-being, preferred activities, sleep patterns, spiritual and religious needs, family dynamics and needs, ethnic practices, and decision-making capacity. The Minimum Data Set (MDS) provides a standardized approach to assessing many aspects of residents’ status that influence the need for nursing care. While rich in the data it generates, the MDS does not address some of the psychosocial and spiritual aspects of residents that are necessary to foster an understanding of their holistic needs. Thus, nurses must supplement the MDS assessment with other factors to gain an understanding of the complete individual. Nurses should encourage all members of the team to share any information they have gained from residents that could assist in individualizing care and identifying needs. Such findings should be documented and incorporated into care planning activities.

The neurological assessment for the medical surgical nurse is less in depth than that of a nurse working in critical care. Any patient, regardless of diagnosis, can experience a neurological deficit. Evaluation of level of consciousness (LOC) and mentation are the most important parts of the neurological exam. The most common neurological issues that develop on a medical-surgical unit include the following: altered mental status (AMS), headaches, stroke, and seizure. AMS is the most common neurologic emergency. It can occur in hospitalized patients due to hypoxia, hypoglycemia, head injury, an infection in the brain, brain tumor, psychological condition, or a metabolic alteration or as an adverse effect of medications. Headaches are the most common neurological complaint. A stroke occurs when there is a disruption of blood flow to the brain resulting in a loss of brain function. There are two types of stroke: ischemic stroke, and hemorrhagic stroke.

This chapter examines transitioning from school into the health care profession and career goals and professional identity. It also reviews guides for students for the job application process and discusses midterm and final evaluation tool and criteria. Students are expected to sign, date, and return their evaluations to the clinical instructor by the beginning of postconference. Evaluations are based on observation, participation, and attendance. Final grades are based on assignments and on the ability to meet the requirements of the clinical class, as stated in the course syllabus. Novice nurses must learn to form a professional identity. Professional identity is the nurse’s own self-concept. The nurse must learn how to perform in the role of the nurse, be knowledgeable, hone didactic skills, and demonstrate professional standards while meeting the professional code of ethics and conduct. New nurses are oriented to their new role of caregiver by a preceptor.